KATELYN MARCEL BUCKNER – Family Nurse Practitioner, NPI 1477044527

KATELYN MARCEL BUCKNER is a healthcare provider. based in Blountville, Tennessee. specializing in NURSE PRACTITIONER. They hold a License No. 24173 (TN). The NPI Number for KATELYN MARCEL BUCKNER is 1477044527

Main info

Female
9 Years Of Experience
Accepts Medicare Assignment
Name
KATELYN MARCEL BUCKNER
NPI
1477044527
Phone
(423) 330-3014
Address
240 CAIN DR
Enumeration Date
24 May 2018
Last Update Date
28 September 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8655241234
Graduation Year
2017 (9 years ago)
PAC ID
4981937281
Group Practice PAC ID
6103907605
Professional Enrollment ID
I20200327002686
Address ID
TN379213313KN4307XPIKE400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness75
Years active:8State licenses:1Digital endpointsOther names

10,656 NURSE PRACTITIONER in TN

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Provider Addresses for KATELYN MARCEL BUCKNER

  • 240 CAIN DR

    BLOUNTVILLE, TN 376174822

    Phone: (423) 330-3014

    Type: Mailing

  • Holston Valley Medical Center, 130, West Ravine Road, Cherokee Village, Kingsport, Sullivan County, Tennessee, 37660, United States

    KINGSPORT, TN 37660

    Phone: (423) 224-5550

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-03-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200327002686INurse PractitionerTNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 37617)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6103907605View full group profile
NameSpecialtyState
C H I R O P R A C T I CTN
Physical Therapist In Private PracticeTN
-TN
P O D I A T R YTN
Nurse PractitionerTN
C H I R O P R A C T I CTN
Nurse PractitionerTN
C H I R O P R A C T I CTN
Physical Therapist In Private PracticeTN
Nurse PractitionerTN

Reviews

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Frequently asked questions

What number should I use to identify KATELYN MARCEL BUCKNER for billing?
Administrative and clinical systems typically use NPI 1477044527 for KATELYN MARCEL BUCKNER.
Is KATELYN MARCEL BUCKNER's NPI status active today?
Active status means KATELYN MARCEL BUCKNER's NPI record is not deactivated in the public file.
How should patients interpret KATELYN MARCEL BUCKNER's specialty?
The extract shows Family Nurse Practitioner for KATELYN MARCEL BUCKNER. Clinical services aligned with this taxonomy classification.
Which community is linked to KATELYN MARCEL BUCKNER?
KATELYN MARCEL BUCKNER shows a connection to Blountville, Tennessee in registry-derived data.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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